This site has a pretty simple structure, but it does contain a lot of
information. This page is therefore a brief overview of the various
categories in the lefthand sidebar, telling you what each page contains.
If you're trying to find something and you're still stuck, try the
Alphabetical Index.

An overview of what the
bloodtests mean, which symptoms you may see, and which treatments you may
be offered. This page is designed to be a starting point for those new to
CKD, especially if you are feeling overwhelmed by the CKD diagnosis,
though it could also be a handy refresher later on.

A
simple explanation of the kidney's functions, and what happens to them in
CKD. This page also briefly discusses how much function is required,
and why cats are often not diagnosed until over two thirds of kidney
function have already been lost.

Information about the causes of CKD, both proven and
suspected. Once CKD is present, it is treated in the same way whatever
the cause (except for
glomerulonephritis, when additional treatments may be appropriate);
so if you're tight for time, skip this page. Also skip this page if you're on a guilt trip: you did not cause your
cat's CKD through e.g. your food choices.

Acute
kidney injury (acute renal failure) is a kind of kidney problem that comes on suddenly,
usually because of an "insult" to the kidneys. It is difficult to treat,
but some cats do make a complete recovery, though others will be left
with residual damage (CKD).

If you're feeling
overwhelmed, this is probably the best page to start with. This page gives an overview
of the main issues of concern for CKD cats. If you focus on any of these
issues that are present, you greatly increase your cat's comfort level
and chances of survival. The other pages in this
chapter go into more detail about these issues.

Most CKD cats have problems with vomiting,
nausea and appetite loss, and often the cause is excess stomach acid. This page
describes the possible symptoms and various treatments available for
these problems.

High phosphorus levels in bloodtest results can make
a CKD cat feel ill and may make the CKD progress faster. Even if the
level is within normal range, this may not be enough. This page
discusses the symptoms of high phosphorus levels and the possible
treatments.

66% of CKD cats develop hypertension. It can
make a cat feel rough, and in the worst case, the cat may go blind or
have a stroke. Fortunately it's easily treated. This page covers
possible symptoms and explains which is the best treatment.

CKD cats often have an imbalance in their potassium
levels. Most of them have levels which are too low, which can cause a
number of problems, especially back leg weakness. This page discusses
symptoms of a potassium imbalance and how to treat low or high potassium
levels.

Metabolic acidosis means
the cat's body is too acidic (which has nothing to do with stomach acid). It is quite common in CKD
cats,
usually in those with more advanced CKD, and this page explains more about the problem and how to deal with it.

It can be emotionally draining dealing with CKD, so this page gives
tips on how to cope with the ups and downs of the CKD rollercoaster,
including worrying about the future, and how to deal with practical
issues, including financial concerns.

The
stories of some CKD cats, all of whom have led high quality and, in
most cases, long lives despite having CKD. Includes cases of young
cats, cats with kidney stones, cats with acute kidney injury etc.

This page
explains more about obtaining urine samples and what these indicate,
including urine specific gravity (USG), proteinuria (excess protein in
the urine) and the diagnosis of urinary
tract infections and kidney infections (pyelonephritis).

There are so many treatment
options that it can seem overwhelming. This page explains which are the
most important treatments, which may be necessary in some circumstances,
and which are optional or not recommended.

Discusses
commonly used antibiotics (Baytril, Convenia, Clindamycin and Clavamox/Synulox)
and painkillers, including meloxicam (Metacam). It includes a treatment
protocol should your cat have been given too much meloxicam and
developed acute kidney injury.

Describes some treatments which are not
mainstream but which have proven to be effective for many CKD cats, such
as slippery elm bark and acupuncture. Also explains which treatments may
not be appropriate, such RenAvast.

Discusses the dietary and nutritional needs of CKD cats. Includes a
discussion of the low protein debate, and explains why low protein is
not necessarily a good idea for cats in the early stages of CKD.

CKD cats
lose Vitamin B through increased urination. This page explains how
supplementation, particularly of Vitamin B12 in the form of
methylcobalamin, can help with problems such as anaemia and appetite
loss.

If your
cat refuses to eat prescription foods, it can help to know the content,
particularly the phosphorus content, of other cat foods. This page
explains how and why I analyse the foods using Dry Matter Analysis
(DMA), and gives a brief overview of what to consider when choosing a
food.

In
2007, a number of cats in the USA (and later in some other countries) suddenly began developing kidney failure.
Some of them died.Some cats survived but were left with CKD. The problem
was eventually traced to cat food ingredients imported from China.
This page explains more about the scandal.

Maintaining hydration is very important for CKD cats. This page
gives a brief overview of the different fluid therapies (oral fluids, intravenous
fluids and subcutaneous
fluids), and explains which is used when.

Intravenous fluids (IV fluids, or a drip) are given into a vein, and are
therefore usually given in hospital. For this reason they are normally
reserved for crisis situations, such as when a cat
crashes. They
are also commonly used before, during and after surgery.

Subcutaneous fluids (sub-Qs or sub-cuts) are given under the skin and
can therefore be given at home. They are used to maintain hydration.
Generally speaking, CKD cats benefit from subcutaneous fluids once their
creatinine is over 3.5 (US) or 300 (international).

This page
gives an overview of the various sorts of fluids (Lactated Ringers,
saline etc.). It also provides tips on which needles to use, how to keep
your cat calm, and generally how to make the process easier for you
both.

Description of
peritoneal dialysis, haemodialysis and continuous renal replacement
therapy. These treatments cost thousands, so are rarely performed on cats, but the information is provided in
case of need.

Heart problems are not unusual in older cats, so you may find yourself
dealing with these as well as CKD. This page explains the different types
of heart problem, describes the various heart medications that may be
used, and discusses how to balance treatment for both CKD and heart
problems.

Hyperthyroidism means that the thyroid is overactive, so the body's metabolic processes
are in overdrive, causing a variety of different problems. Treating
hyperthyroidism is therefore essential, but must be done cautiously
because treating it may unmask existing but hidden CKD. This page explains
more about hyperthyroidism and how to juggle both conditions.

Pancreatitis is inflammation of the pancreas. It is fairly common in CKD
cats, and shares some of the same symptoms. If your cat has relatively low
creatinine levels but is acting sicker than you would expect, with
vomiting and severe appetite loss, read this page.

Most cats
eventually develop dental problems, and many of them eventually need
surgery. This page explains how to reduce the risk of dental problems, and
what precautions are necessary in cats who need dental surgery.

Since CKD is ultimately terminal, eventually you will have to say goodbye
to your cat. This page contains information on facing up to this painful
parting, and
explains the symptoms and behaviour
which you may see in your cat's last few days or hours. This page also
contains a discussion on whether to opt for euthanasia, and a
description of what to expect during the procedure if so.

Harpsie was my second cat. He was an adorable blond Persian who had a host
of ailments but who nevertheless lived to the age of 14. He had
PKD,
which was diagnosed at the age of 7, but it never developed into CKD.